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2008, Número 1

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Rev Mex Anest 2008; 31 (1)


Mecanismos generadores y consideraciones terapéuticas futuras de la polineuropatía diabética dolorosa

Betancourt-Sandoval JA, Covarrubias-Gómez A, Guevara-López U

Idioma: Español
Referencias bibliográficas: 55
Paginas: 28-36
Archivo PDF: 142.32 Kb.


RESUMEN

La neuropatía diabética dolorosa (NPDD) es una complicación crónica de la diabetes mellitus (DM) observada frecuentemente en la práctica clínica. Se ha reportado que la prevalencia de DM en la población general es del 6.9% y que la prevalencia de NPDD en los pacientes diabéticos es del 20 al 24%. La neuropatía diabética se caracteriza por la presencia de debilidad distal, ausencia de reflejos tendinosos, dolor y pérdida distal de la sensibilidad en extremidades. Estos hallazgos, son el resultado de los diversos mecanismos que se encuentran involucrados en su etiología. Por ello, diversos autores sugieren que el abordaje terapéutico debe fundamentarse en sus mecanismos de producción. El objetivo terapéutico principal de la NPDD es la obtención del control de la glicemia y del dolor. Para alcanzarlo, se ha propuesto el empleo de diversos fármacos entre los que se encuentran: inhibidores de la aldosa-reductasa y de la recaptura de serotonina, antidepresivos tricíclicos, anticonvulsivantes, mexiletina, tramadol, levodopa, ácido gamma-linoleico, ácido alfa-lipoico, dextrometorfan, capsaicina, estimulación nerviosa eléctrica transcutánea, acupuntura, entre otros. Con base en estas consideraciones, nuestro objetivo es proporcionar al lector elementos actuales que faciliten la identificación, evaluación y tratamiento de esta entidad.


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